Predictive Value for Malignancy of the Thyroid Nodule Macroscopically

Rogério Aparecido Dedivitis; Sergio Dias do Couto Netto; Mario Augusto Ferrari de Castro; Elio Gilberto Pfuetzenreiter Jr.; Carlos Eduardo Molinari Nardi; Emanuel Casotti Duque de Barbara

doi:10.7162/S1809-48722010000200013

Arquivos Internacionais de Otorrinolaringologia, Table of Contents

Arquivos Internacionais de Otorrinolaringologia 2010; 14(02): 225-230
DOI: 10.7162/S1809-48722010000200013

Original Article

Thieme Publicações Ltda Rio de Janeiro, Brazil

Predictive Value for Malignancy of the Thyroid Nodule Macroscopically

Valor de Predição para Malignidade dos Aspectos Macroscópicos do Nódulo Tireoidiano

Authors

Rogério Aparecido Dedivitis

^*Full Professor, Faculty of Medical Sciences University Center Lusíada UNILUS, Santos, Chief, Division of Surgery and the Division of Teaching Hospital Ana Costa, Santos, Chief of Head and Neck Surgery of the Brotherhood of Santa Casa da Misericordia Santos, Professor, Graduate Course in Health Sciences Complex Hospital Heliopolis, São Paulo.
Sergio Dias do Couto Netto

^**Ex-Resident of General Surgery, Hospital Ana Costa, Santos / SP.
Mario Augusto Ferrari de Castro

^***Resident of the Head and Neck Surgery, Hospital Ana Costa, Santos, Master Course Graduate Health Sciences University Center Lusíada UNILUS, Santos, Professor, Department of Surgery, Faculty of Medical Sciences University Center Lusíada UNILUS , Santos.
Elio Gilberto Pfuetzenreiter Jr.

^****By Master Course Graduate Health Sciences, Heliopolis Hospital Complex HOSPHEL, São Paulo, Professor, Department of Surgery, Faculty of Medical Sciences University Center Lusíada UNILUS, Santos; Surgeon Assistant Surgery Service Head and Neck Surgery, Hospital Ana Costa and the Brotherhood of Santa Casa de Santos.
Carlos Eduardo Molinari Nardi

^*****Resident in General Surgery, Hospital Ana Costa, Santos / SP.
Emanuel Casotti Duque de Barbara

^******Ex-Scholar, School of Medical Sciences of Santos, the Foundation Lusíada UNILUS under internship at Hospital Ana Costa, Santos / SP.

Abstract

Summary

Introduction The fine needle aspiration (FNA) is a method of high accuracy in the preoperative diagnosis of thyroid nodules, but the “follicular” remains a factor of failure. Furthermore, the usefulness of intraoperative examination of freezing is controversial. Macroscopic aspects of thyroid nodules may increase the diagnostic accuracy of preoperative and intraoperative FNA biopsy and freezing.

Objective To evaluate the macroscopic aspects of the surgical specimen in the decision facing the nodular disease of thyroid gland.

Methods During 2007, 85 patients underwent surgical treatment for thyroid nodular diseases were evaluated by prospective and macroscopic aspects of 125 nodules were compared with histopathological findings.

Results We found that the pattern of recent growth, the presence of adhesions of the thyroid, absence of hemorrhage, necrosis and poor demarcation of the nodule had statistical significance in the outcome of malignant disease.

Conclusion Pattern of growth, thyroid adhesions, necrosis and poor demarcation of the nodule are predictors of malignancy, while the presence of hemorrhage is a protective factor.

Resumo

Introdução A punção aspirativa por agulha fina (PAAF) é um método de alta acurácia no diagnóstico pré-operatório dos nódulos tireoidianos, mas o “padrão folicular” segue sendo um fator de falha. Por outro lado, a utilidade do exame intra-operatório de congelação é controversa. Aspectos macroscópicos dos nódulos tireoidianos podem aumentar a acurácia diagnóstica pré e intra-operatória da PAAF e a biópsia de congelação.

Objetivo Avaliar os aspectos macroscópicos do espécime cirúrgico na tomada de decisão frente à doença nodular da glândula tireoide.

Método Durante 2007, 85 pacientes submetidos a tratamento cirúrgico por doença nodular tireoidiana foram avaliados por estudo prospectivo e os aspectos macroscópicos de 125 nódulos foram comparados aos achado histopatológicos.

Resultados Foi observado que o padrão de crescimento recente, a presença de aderências da tireoide, a ausência de hemorragia, a presença de necrose e a má delimitação do nódulo tiveram significado estatístico no resultado de doença maligna.

Conclusão Padrão de crescimento, aderências da tireoide, necrose e a má delimitação do nódulo são fatores indicativos de malignidade, enquanto a presença de hemorragia é fator protetor.

Keywords

thyroid neoplasms - thyroidectomy - sensitivity and specificity - biopsy - needle - frozen sections

Palavras-chave

neoplasias da glândula tireoide - tireoidectomia - sensibilidade e especificidade - biópsia por agulha - secções congeladas

Full Text

References

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